https://doi.org/10.4081/aiua.2022.2.134

Endoscopic laser en bloc removal of bladder tumor. Surgical radicality and improvement of the pathological diagnostic accuracy

Vol. 94 No. 2 (2022)
Published: June 29, 2022
Laser; Bladder tumor; Endoscopic resection; En-bloc; Diode.
Abstract Views: 1716
pdf: 446
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Rosario Leonardi
urologialeonardi@gmail.com
Casa di Cura Musumeci GECAS, Gravina di Catania (CT), Italy.
Alessandro Calarco
“Cristo Re” Hospital, Rome, Italy.
Lorenzo Falcone
Casa di Cura Musumeci GECAS, Gravina di Catania (CT), Italy.
Vincenzo Grasso
Casa di Cura Musumeci GECAS, Gravina di Catania (CT), Italy.
Marco Frisenda
Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy.
Antonio Tufano
Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy.
Pietro Viscuso
Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy.
Antonio Rossi
“Cristo Re” Hospital, Rome, Italy.
Lorenzo Memeo
IOM (Istituto Oncologico del Mediterraneo), Viagrande (CT), Italy.

Introduction: Bladder cancer is one of the most common tumors among the general population. The first surgical approach to the tumor is often the transurethral resection with monopolar or bipolar loop. Recently, laser energy has become an alternative for resection of small bladder tumor, because it allows to obtain high quality samples with the “en bloc” technique. Our study aims to show the results of endoscopic diode laser treatment of bladder tumor up to three centimeters in maximum diameter. Materials and methods: 189 patients underwent “en bloc” resection with diode dual length laser (980 nm-1470 nm). Follow up was over 12 months. Patients age range was from 45 to 75 years. Maximum diameter of the lesions was 3.0 cm. For each patient, a cold forceps biopsy sample was performed. Results: All samples collected presented detrusorial layer. Pathological exam showed: 28 (14.8%) Ta, G1-G2; 7 (3.7%) T3, G2-G3; 14 (7.4%) T1, G2-G3 and 140 ( 74.1%) Ta, G2-G3. No complications occurred during or after surgery. At a median follow-up period of 6 months, we had no recurrence in the previous site of tumor. In the follow up at 3/6/12 months in 4 cases we had recurrence in different sites of bladder wall. Conclusions: Laser “en bloc” resection is an effective, feasible, and safe treatment for bladder tumor. It could be a valid alternative to monopolar and bipolar resection in small bladder cancer treatment.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
American Cancer Society. Cancer Facts & Figures 2022. Atlanta, Ga: American Cancer Society; 2022.
Richters A, Aben KKH, Kiemeney LALM. The global burden of urinary bladder cancer: an update. World J Urol. 2020; 38:1895-1904. DOI: https://doi.org/10.1007/s00345-019-02984-4
Rozanec JJ, Secin FP. Epidemiología, etiología, prevención del cáncer vesical (Epidemiology, etiology and prevention of bladder cancer.). Arch Esp Urol. 2020; 73:872-878.
Cumberbatch MGK, Foerster B, Catto JWF, et al. Repeat transurethral resection in non-muscle-invasive bladder cancer: a systematic review. Eur Urol. 2018; 73:925-933. DOI: https://doi.org/10.1016/j.eururo.2018.02.014
Territo A, Bevilacqua G, Meneghetti I, et al. En bloc resection of bladder tumors: indications, techniques, and future directions. Curr Opin Urol. 2020; 30:421-427. DOI: https://doi.org/10.1097/MOU.0000000000000737
Mao X, Zhou Z, Cui Y, et al. Outcomes and complications of bipolar vs. monopolar energy for transurethral resection of bladder tumors: a systematic review and meta-analysis of randomized controlled trials. Front Surg. 2021; 8:583806. DOI: https://doi.org/10.3389/fsurg.2021.583806
Burke N, Whelan JP, Goeree L, et al.. Systematic review and metaanalysis of transurethral resection of the prostate versus minimally invasive procedures for the treatment of benign prostatic obstruction. Urology. 2010; 75:1015-22. DOI: https://doi.org/10.1016/j.urology.2009.08.015
Puppo P, Bertolotto F, Introini C, et al. Bipolar transurethral resection in saline (TURis): outcome and complication rates after the first 1000 cases. J Endourol. 2009; 23:1145-9. DOI: https://doi.org/10.1089/end.2009.0011
Xu J, Wang C, Ouyang J, et al. Efficacy and safety of transurethral laser surgery versus transurethral resection for non-muscle-invasive bladder cancer: a meta-analysis and systematic review. Urol Int. 2020; 104:810-823. DOI: https://doi.org/10.1159/000506655
Korn SM, Hübner NA, Seitz C, et al. Role of lasers in urology. Photochem Photobiol Sci. 2019; 18:295-303. DOI: https://doi.org/10.1039/C8PP00409A
Enikeev D, Shariat SF, Taratkin M, et al. The changing role of lasers in urologic surgery. Curr Opin Urol. 2020; 30:24-9. DOI: https://doi.org/10.1097/MOU.0000000000000695
Long G, Zhang Y, Sun G, et al. Safety and efficacy of thulium laser resection of bladder tumors versus transurethral resection of bladder tumors: a systematic review and meta-analysis. Lasers Med Sci. 2021; 36:1807-1816. DOI: https://doi.org/10.1007/s10103-021-03272-7
Razzaghi MR, Mazloomfard MM, Yavar M, et al. Holmium LASER in comparison with transurethral resection of the bladder tumor for non-muscle invasive bladder cancer: randomized clinical trial with 18-month follow-up. Urol J. 2021; 18:460-465.
Hashem A, Mosbah A, El-Tabey NA, et al. Holmium Laser Enbloc resection versus conventional transurethral resection of bladder tumors for treatment of non-muscle-invasive bladder cancer: a randomized clinical trial. Eur Urol Focus. 2021; 7:1035-1043. DOI: https://doi.org/10.1016/j.euf.2020.12.003
Mithani MH, Khalid SE, Khan SA, et al. Outcome of 980 nm diode laser vaporization for benign prostatic hyperplasia: A prospective study. Investig Clin Urol. 2018; 59:392-398. DOI: https://doi.org/10.4111/icu.2018.59.6.392
Leonardi R. The LEST technique: Treatment of prostatic obstruction preserving antegrade ejaculation in patients with benign prostatic hyperplasia. Arch Ital Urol Androl. 2019; 91:35-42. DOI: https://doi.org/10.4081/aiua.2019.1.35
Zhang J, Li J, Wang X, et al. Efficacy and safety of 1470-nm diode laser enucleation of the prostate in individuals with benign prostatic hyperplasia continuously administered oral anticoagulants or antiplatelet drugs. Urology. 2020; 138:129-133. DOI: https://doi.org/10.1016/j.urology.2020.01.008

How to Cite

Leonardi, R., Calarco, A., Falcone, L., Grasso, V., Frisenda, M., Tufano, A., Viscuso, P., Rossi, A., & Memeo, L. (2022). Endoscopic laser en bloc removal of bladder tumor. Surgical radicality and improvement of the pathological diagnostic accuracy. Archivio Italiano Di Urologia E Andrologia, 94(2), 134–137. https://doi.org/10.4081/aiua.2022.2.134

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.